动脉瘤性蛛网膜下腔出血动脉瘤栓塞治疗后腰大池持续外引流的疗效分析

发布时间：2018-06-30 20:01

本文选题：腰大池持续外引流 + 动脉瘤栓塞　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：分析动脉瘤性蛛网膜下腔出血(aSAH)在动脉瘤栓塞治疗后采用腰大池持续外引流的疗效。方法：回顾性分析2008年8月-2013年8月广西医科大学第一附属医院神经外科收治的75例颅内动脉瘤破裂并蛛网膜下腔出血患者的资料,其中35例在其动脉瘤介入栓塞后24h内行腰大池持续外引流,该组设为治疗组；另外40例在动脉瘤栓塞后常规行腰椎穿刺术,设为对照组。比较两组患者术后头痛时间、术后1周GCS评分改善情况、术后第3天及第7天Fisher评分改善情况、症状性脑血管痉挛发生率、术后3周脑积水发生率及GOS评分良好率。结果：治疗组头痛时间明显缩短(P0.01)；术后1周治疗组GCS评分改善优于对照组(P0.05)；术后第3天及第7天Fisher评分改善明显优于对照组(P0.01)；治疗组症状性脑血管痉挛及脑积水发生率低于对照组(P0.05)；术后3周GOS评分良好率治疗组高于对照组(P＜0.05)。结论：aSAH患者在动脉瘤栓塞治疗后早期采用腰大池持续外引流能较快改善患者头痛症状；短期内GCS评分改善明显；蛛网膜下腔中积血清除速度明显加快；降低了脑血管痉挛与脑积水发生率；改善患者预后与生存质量。
[Abstract]:Objective: to analyze the effect of continuous external drainage of lumbar cistern after embolization of aneurysm with aneurysm subarachnoid hemorrhage (aSAH). Methods: from August 2008 to August 2013, 75 patients with ruptured intracranial aneurysms and subarachnoid hemorrhage in the Neurosurgery Department of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. 35 cases were treated with lumbar cistern continuous external drainage within 24 hours after embolization of aneurysms, the other 40 cases were treated with lumbar puncture after embolization of aneurysms, as control group. The time of headache, the improvement of GCS at 1 week after operation, the improvement of Fisher score on the 3rd and 7th day after operation, the incidence of symptomatic cerebral vasospasm, the incidence of hydrocephalus 3 weeks after operation and the good rate of GOS score were compared between the two groups. Results: the headache time of the treatment group was significantly shortened (P0.01), the GCS score of the treatment group was improved better than that of the control group at 1 week after operation (P0.05), the Fisher score of the treatment group was significantly better than that of the control group on the 3rd and 7th day after operation (P0.01). The incidence of symptomatic cerebral vasospasm and hydrocephalus in the treatment group was lower than that in the control group (P0.05), and the good GOS score rate in the treatment group was higher than that in the control group 3 weeks after operation (P < 0.05). Conclusion continuous external drainage of lumbar cistern can improve headache symptoms in early stage after embolization of aneurysms, improve GCS score significantly in short term, and accelerate the clearance rate of subarachnoid hemorrhage in the early stage after embolization of aneurysms. It reduces the incidence of cerebral vasospasm and hydrocephalus and improves the prognosis and quality of life.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.12

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